Article
Cyanoacrylate versus fibrin glue in corneal perforations
Search Medline for
Authors
Published: | September 18, 2006 |
---|
Outline
Text
Objective
To compare clinical results from application of cyanoacrylate versus fibrin glue for occlusion in cases with corneal perforations as a result of autoimmune disease or ocular herpes.
Methods
5 patients with corneal perforations up to 2 mm in diameter and positive Seidel’s sign were included in our study. One patient (corneal perforation associated with ankylosing spondilitis) was treated with autologous fibrin glue. In the other 4 patients (three with perforated herpetic ulcer and one with corneal ulcer associated with rheumatoid arthritis) we applied cyanoacrylate glue. Soft contact lens was placed on the cornea after glue consolidation.
Results
Excellent restoration of anterior chamber was achieved almost immediately after glue application. Severe hypotony was overcome and normal ocular pressure was measured on the first postoperative day. In spite of combined immunosuppressive therapy after glue application in the patient with ankylosing spondilitis the aggressive autoimmune melting of the cornea continued. All patients treated with cyanoacrylate glue kept corneal integrity even after removal of the glue two months later. During follow up period visual results were evaluated and underlying eye diseases treated as appropriate.
Conclusions
Application of autologous fibrin glue can provide temporary corneal occlusion, but it did not prevent further corneal melting in our patient with autoimmune disease - ankylosing spondilitis. Cyanoacrilate glue applied for small corneal lesions gives good long term results, because of its ability to adhere and hold fast for two or more months, during the self-healing processes restore ocular surface integrity.